=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912824350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTEGRATIVE HEALING COUNSELING SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2026
-----------------------------------------------------
Last Update Date | 07/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1516 E CONCORD ST
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-5412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-701-4230
-----------------------------------------------------
Fax | 407-783-0188
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1516 E CONCORD ST
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-5412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-701-4230
-----------------------------------------------------
Fax | 407-783-0188
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DOMINIQUE BARRITT
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 407-701-4230
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------